Some maternal effects of lumbar epidural analgesia during labour in pre-eclamptic patients

The effects of continuous epidural analgesia for labor were studied in 20 women with preeclampsia among those who admitted to El-Shatby University Maternity Hospital. Maternal hemodynamic, renal functions, arterial blood gas findings together with fetal cardiotochography were investigated. Significant reduction of pulse rate and mean blood pressure occurred 2 hours after epidural with insignificant effects on both CFR, RPF and U/PK; however, there was significant increase in the three parameters after delivery. Maternal blood gas analysis showed significant increase in PaO2 and pH, late patterns occurred in three subjects returned to normal beat to beat variation with head up position and oxygen administration. Continuous epidural analgesia was recommended as a useful method for labor in patients with preeclampsia

effect of hydration and epidural analgesia on the P-50 in pre-eclamptic patients

Twenty subjects suffering from preeclampsia were included in this study and divided into two groups: 11 cases in GI [mild] and 9 cases in GII [severe] PET. P-50 in both groups was shifted to the left. After hydration only, insignificant changes in P-50 were observed; but after epidural analgesia, a significant shift to the right was observed, this may be attributed to the significant improvement of pH. Significant increase in venous oxygen tension and venous oxygen saturation in both groups which may result from decreased oxygen needs to the paralyzed part and vasodilatation with increase blood flow to affected organs. An elevation in PH enhanced 2,3 PDG phosphatase. This led to an increased synthesis of 2,3-DPG and increased level of 2,3- DPG which might be the cause of increased P-50 after epidural analgesia